[Staphylococcus aureus colonization and risk of developing a subsequent peritonitis episode caused by an identical strain, among pediatric patients admitted for continuous ambulatory peritoneal dialysis].
OBJECTIVE
To determine the risk of pediatric end stage renal disease patients undergoing continuous ambulatory peritoneal dialysis to develop a subsecuent peritonitis episode caused by an identical Staphylococcus aureus (SA) strain.


METHODS
Longitudinal survey carried out in a CAPD center at the nephrology department of a tertiary care (reference) pediatric hospital. At recruitment, swabs were collected from the nares, exit site, and hands, respectively from 29 patients who were followed-up for a mean period of 369 +/- 80 days (range 224-516 days), and from the nares and hands of their mothers. Isolated SA strains were kept in BHI glycerol at -20 degrees C for subsequent analysis. Peritonitis episodes were monitored and registered. When a SA strain was isolated from the dialysate effluent it was compared with the preexisting strain by PFGE.


RESULTS
We report 7 SA-mediated peritonitis episodes among 6 patients. Only one of these patients was a previous nasal carrier, and 2 were previous exit site carriers of the same SA strain. The relative risk of developing a peritonitis episode caused by a preexistent SA strain colonizing the exit site was 0.948. The relative risk of developing a peritonitis episode caused by a preexistent SA strain colonizing the nares was 0.525.


CONCLUSIONS
SA carriers do not appear to be at higher risk of developing peritonitis by an SA related strain than non-carriers. Our results do not lend support to the recommendation of monitoring nasal or exit site carrier status in CAPD patients. The need of attempting to eradicate SA from nose or exit site is also questioned.
Miranda-Novales
Guadalupe
G
Unidad de Investigación Médica en Epidemiología Hospitalaria, Hospital de Pediatría, México DF, México.
Aburto y-Huesca
Rafael
R
Leaños-Miranda
Blanca
B
Mendoza-Guevara
Leticia
L
Paniagua
Ramón
R
Amato
Dante
D
D000293:Adolescent; D002353:Carrier State; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008137:Longitudinal Studies; D008297:Male; D009262:Nails / Q000382:microbiology; D009666:Nose / Q000382:microbiology; D010531:Peritoneal Dialysis, Continuous Ambulatory; D010538:Peritonitis / Q000453:epidemiology* / Q000382:microbiology*; D018570:Risk Assessment; D012307:Risk Factors; D013211:Staphylococcus aureus / Q000302:isolation & purification*